Clinical Competency # 549-3-84

1. Clinical Competency# 549-3-84 Robert Thompson Team 1

2. Patient History • 67 Year old Caucasian Male • Controlled hypertension/blood pressure • Vytorin for hypercholesterolemia • Previous tobacco use 40 years ago (cigarettes) • No known allergies • Amlodipine and Triamterene for hypertension • Pt presented for replacement of lower left molars

3. Lesion Description • Hard tissue overgrowth (tori) • Pink • Large, multiple, bilateral • Raised and covered with keratinized tissue • Well-defined

4. Clinical Photograph

5. Patient Dialogue • Are you aware that there are bony overgrowths in your mouth? • Have you noticed any changes in size? • Do they ever interfere with talking, eating, swallowing? • Have they ever been traumatized? (i.e. have you hit them with something and they were sore after?) • Do you ever notice that you clench or grind your teeth? Do you wake up with sore jaws? Do you wake up with headaches? • Do you live a stressful/hectic life?

6. Diagnosis • Differential diagnosis: Ossifying fibroma • Can be mistaken for mandibular tori because they are often found on the gingiva • This can be ruled out via palpation • Differential diagnosis: Pyogenicgranuloma • Can be mistaken for mangibulartori clinically • Rule out via palpation and slight anatomical differences

7. Diagnosis • Provisional diagnosis: Mandibular Tori • Mandibular tori generally are located on the lingual side of the mandible near the pre-molars • Treatment: Treatment is unnecessary unless the patient wants a mandibular partial in the future. The tori can also be removed if they are constantly being traumatized or if they are causing the patient difficulty in swallowing, eating, chewing, or speaking. • The tori should be palpated on the oral exam to be sure they are free of pathology